RESUMEN
Fundic gland polyps (FGPs) are benign epithelial polyps usually located in the gastric body and fundus. Here, we describe the case of an elderly woman who presented with symptomatic anemia, abdominal pain, and weight loss. There was also history of chronic use of proton pump inhibitors for the symptomatic treatment of dyspepsia. Reflux esophagitis, duodenal ulcers, and multiple gastric polyps suspicious of malignancy were found at endoscopy. A large pedunculated antral polyp measuring more than 10mm in the largest dimension and other smaller polyps in the body and fundus were removed completely by cold snare and sent for histopathologic evaluation. The polyps were eventually diagnosed as benign fundic gland polyps. Biopsies taken from the gastric mucosa also showed Helicobacter pylori-associated gastritis. Helicobacter pylori eradication therapy was commenced with the resultant resolution of symptoms. No surveillance is required for FGPs because they are not premalignant lesions. However, large FGPs require excision and thorough histopathologic evaluation to rule out atypia and malignancy. This index case further highlights a possible causal link between the chronic use of proton pump inhibitors and the development of fundic gland polyps.
RESUMEN
Intestinal spirochetosis is a gastrointestinal infection with vague and inconsistent symptoms. It similarly presents multiple gastrointestinal diseases such as inflammatory bowel disease and appendicitis. We present a case of a 27-year-old female with intestinal spirochetosis who was later found to have subacute appendicitis. Further understanding of the disease and a set of criteria may have to be created for its management.